Depersonalization/derealization (dpdr) is known to occur across mood and anxiety disorders (MAD) and has been proposed as a marker of worse illness. However, despite the well-known clinical association, there are no epidemiological data on the relationship between dpdr and MAD. In this NCS-R analysis clinically significant dpdr (DPDR-C) was defined as "sometimes" or "often" past-month...
Abstract: The social isolation created by the COVID-19 lockdown prompted a dramatic increase in use of the internet, Zoom, and Skype. It also brought greater attention to the subject of internet addiction. New books and studies took a closer look at problematic internet use and issues related to increased time spent online, as well as increased dependence on smartphones for social interaction....
Abstract Depersonalization is the third most common psychiatric symptom, yet clinicians and lay people still know little about its presentation and treatment. While it can indeed be a symptom accompanying other mental illnesses, it is also a full-blown disorder unto itself, recognized by every major diagnostic manual. Chapter 1 discusses the symptoms of depersonalization/derealization disorder...
Abstract This chapter explores the use of cognitive-behavioral and mindfulness-based psychotherapy techniques in the treatment of depersonalization/derealization disorder (DDD). Cognitive-behavioral therapy seeks to identify and change distorted thinking patterns, as well as avoidant and ritualistic behaviors. Ten cognitive distortions, commonly encountered in depersonalization/derealization...
Abstract This chapter examines the various biological factors that may be involved in depersonalization/derealization (dpdr) and depersonalization/derealization disorder (DDD). The role of sensory association cortical areas and corticocortical dysconnectivity models are discussed, vis-à-vis the perceptual alterations characteristic of the disorder. The role of the limbic system and the...
Abstract The chapter elaborates psychodynamic psychotherapy approaches to the treatment of depersonalization/derealization disorder (DDD), intertwined with illustrative case examples. The chapter starts with more classic psychoanalytic reflections on the nature and treatment of depersonalization/derealization, including the often-assumed chronicity and refractoriness of the condition, the use...
Abstract This chapter describes how to diagnose depersonalization/derealization disorder (DDD) according to the latest edition of the Diagnostic and Statistical Manual of Mental Disorders, criterion by criterion, and provides clinical vignettes relevant to diagnosis. Each of the five DSM diagnostic criteria is presented and discussed. Criterion A1 requires persistent or recurrent episodes of...
Abstract Feeling Unreal presents a comprehensive and contemporary overview of depersonalization/derealization disorder. The book examines in depth, and through many personal vignettes, the many shapes and forms that the dissociative state of mind known as depersonalization takes, its conceptualization over the past two centuries of psychiatric study, its detection, and its measurement. The...
Abstract The chapter focuses on the many nuances of depersonalization/derealization (dpdr) experiences, and on how to measure dpdr symptoms. The meanings of the word “unreal,” as well as shifts in the phenomenology of the disorder over the past century are discussed. Two self-report questionnaires are provided and explicated. The Dissociative Experiences Scale is a 28-item questionnaire that...
Abstract This chapter reviews the steps involved in evaluating patients who may have depersonalization/derealization disorder (DDD), along with basic psychoeducational and psychotherapeutic principles that facilitate the initiation of treatment. Nine topics that often come up at the start of psychotherapy with DDD patients, and are very helpful to address early on, are formulated and discussed....
Previous studies have documented that in a substantial minority of individuals with depersonalization disorder, onset is first triggered by illicit drug ingestion. The goal of this study was to systematically compare a large sample of individuals with drug-initiated (D) versus non-drug-initiated (ND) chronic depersonalization. We conducted an internet survey of 394 adults endorsing DSM-IV-TR...
ABSTRACT Depersonalization disorder (DPD) is characterized by a subjective sense of detachment from one's own being and a sense of unreality. An examination of the psychobiology of depersonalization symptoms may be useful in understanding the cognitive-affective neuroscience of embodiment. DPD may be mediated by neurocircuitry and neurotransmitters involved in the integration of sensory...
Abstract The human brain, the only organ capable of studying itself, has in the last century turned its attention toward the mysterious phenomenon of depersonalization, examining it from many perspectives. Depersonalization disorder (DPD) remains one of the most frequently misdiagnosed or underdiagnosed conditions in modern psychiatry. Why? Likely for several reasons. DPD is often accompanied...
Abstract The idea that reality is subjective, constructed from our own perceptions, is quite an ancient concept. “We are what we think. All that we are arises with our thoughts. With our thoughts, we make the world,” said the Buddha. Depersonalization, a serious disruption in a person’s thoughts or sensations about their individual self, understandably alters their entire world. A person may...
Abstract Einstein’s advice, above, is particularly relevant when it conies to discussing the human brain, the most complex structure in all creation. While more is known about the brain than ever before, mass culture has developed a tendency to liken its functions to that of a computer, or explain serious disorders in terms of simple chemical imbalances. Such generalizations just don’t do the...
Abstract Can depersonalization be successfully treated with psychotherapy? Although traditionally the psychotherapy literature has been rather pessimistic on this issue, more recent advances in psychotherapy technique aimed specifically at treating this condition leave us with more reason to be optimistic. To say that psychotherapy works, or always works fully, may be misleading or overly...
Abstract: Like any other psychiatric condition, the diagnosis of depersonalization disorder (DPD) is made clinically, by meeting with the patient and conducting a thorough evaluation interview. Descriptions of the symptoms, as we have described throughout this book, and as spelled out in the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV), serve as the point of...
Abstract: Dissociative disorders in general are known to be founded in experiences of trauma or abuse. They are conceptualized as the human psyche’s way of coping with intolerable circumstances—a means of escape to assure survival, no matter what the price. Depersonalization disorder (DPD) is classified by modern American psychiatry within the dissociative disorders, but its traumatic causes...
Depersonalisation disorder is characterised by prominent depersonalisation and often derealisation, without clinically notable memory or identity disturbances. The disorder has an approximately 1 : 1 gender ratio with onset at around 16 years of age. The course of the disorder is typically long term and often continuous. Mood, anxiety and personality disorders are often comorbid with...